We need to break the status quo to fix our broken health care system

We need to break the status quo to fix our broken health care system

Michigan families are sick and tired of the prices they have to pay for health care — to their insurance companies and out-of-pocket bills for appointments, medicine, and treatments. To lower health care costs, we must address the deep-rooted problems created by failed government policies. We need to break the status quo to fix our broken health care system.

Politicians promised the Affordable Care Act would make health care more affordable. The exact opposite happened. In the dozen years since the law took effect, large insurance companies have raked in record profits while denying more claims to regular Americans. Families were told the system would put patients first. Instead, insurers wrote themselves a blank check — and Michigan families are paying for it through rising premiums, denied claims, and mounting medical debt.

The numbers tell a clear story of just how broken our system is. Average family premiums have climbed from less than $16,000 in 2012 to almost $27,000 today — all while Obamacare has been the law of the land. Deductibles have also continued to rise, forcing families to pay thousands out of their own pockets before coverage kicks in. Meanwhile, in the same period, insurance companies' revenues and profits have skyrocketed. In 2023, the nation's largest health insurers collectively generated well over $1 trillion in revenues.

To make matters worse, claim denial rates have risen steadily, with some insurers rejecting nearly one in five claims on the individual marketplace. For families facing tragedies like cancer, chronic illness, or emergency care, the fight isn't just about getting better; it's about getting their insurer to pay.

Supporters of the Affordable Care Act often point to the COVID-era "premium tax credits" as a fix to the broken system. But these corporate payouts didn't fix the problem — they entrenched it. The money never went to patients. It went straight to insurance companies, shielding them from competition and rewarding higher prices with larger taxpayer-funded payouts. When subsidies rise automatically alongside premiums, insurers have little incentive to control costs. Michigan families deserve better than a system that masks rising costs with taxpayer dollars while insurers pocket the difference.

We don't need to accept this failed status quo. We need to boldly rethink the way we deliver health care in this country, and that starts with common-sense reforms that prioritize the patients.

First, Americans need real transparency for prices and claim denials. Patients should know the cost of care before receiving it, just as they would for any other service. They should also know how many claims insurance providers are denying before choosing their plan. When hospitals and insurers are transparent, competition can finally work. High-quality, affordable providers will thrive, and those that overcharge will be forced to change.

It's critical that we demand accountability from insurers who game the system. When insurers deny legitimate in-network claims, they should face real consequences. Congress should also reform the medical loss ratio — the share of premiums that must go to actual health care rather than overhead and profits. Currently, insurers are gaming the ratio by buying up hospitals and pharmacies to make their profits look smaller while jacking up their prices. Meanwhile, as much as one-third of the money Americans spend on health care is wasted in our broken system. Your premium dollars should fund care, not bloated executive compensation. It's ridiculous that families pay so much for coverage only to fight tooth and nail when they actually need it.

Expanding health savings accounts and making them more accessible for all Americans is another essential step. These tax-exempt accounts bypass insurance companies and allow families to own their health care dollars, not lose them when they change jobs or plans.

The Affordable Care Act promised affordability and patient-centered care. What it delivered was record profits for insurers, and record costs, denials, and debt for Michigan families. The system is broken, and propping it up with more subsidies won't fix it.

Frustration with this system crosses party lines. Americans of all backgrounds are fed up with paying more and getting less. It's time to admit the failure, reject the status quo, and pursue reforms that return power to where it belongs: with patients and their doctors.

Congressman Tom Barrett, Michigan's 7th District

Tim Golding, Michigan State director for Americans for Prosperity